Centers for Medicare and Medicaid Services (U.S.), Delivery of Health Care, Economics, Fraud, Health Expenditures
Conditions
Brief summary
Abusive prescribing exposes patients to unnecessary health risks and results in wasteful public expenditures. This study will evaluate an innovative approach to fighting abusive prescription: sending letters to suspected inappropriate prescribers warning them that they are outliers compared to their peers and have been flagged for review. The study will target high prescribers of Seroquel (Quetiapine), an atypical antipsychotic. Using claims data, the investigators will assess the effect of the letters on prescribing of Seroquel, receipt of Seroquel by patients, substitution behavior by prescribers and patients, and health outcomes of patients.
Interventions
OTHERPlacebo letter
The placebo letter describes a new rule in Medicare that requires prescribers to enroll in Medicare
OTHERInitial Informative letter
The intervention is a letter that describes the Seroquel prescribing activity of the individual in comparison to a peer group of similar prescribers. It highlights the fact that the prescriber's activity is highly unlike her peers.
OTHERFollowup Informative Letter
The followup informative letter is identical to the initial informative letter except it provides an update on more recent prescribing rather than a description of earlier prescribing.
Sponsors
Centers for Medicare and Medicaid Services
General Services Administration (GSA)
Abdul Latif Jameel Poverty Action Lab
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* General care practitioner * Outlier with respect to the count of Seroquel prescription drug treatments relative to peer group of prescribers in 2013 and 2014 * Outlier with respect to the count of Seroquel 30-day equivalent prescription drug treatments relative to peer group of prescribers in 2013 and 2014
Exclusion criteria
* Deceased
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 30-day equivalent prescribing of Seroquel treatments | 9 months | The prescribing of Seroquel over the 9 months following the initial sending of the letters. Prescribing is defined as the total days supply of Seroquel attributed to the prescriber, expressed in 30-day equivalents i.e. divided by 30. |
Secondary
| Measure | Time frame |
|---|---|
| 30-day equivalent prescribing of Seroquel treatments | 3 months |
Outcome results
None listed